Effects of eye movement training on balance and ocular motor function in community-dwelling Japanese school-aged children: a pilot study using a single-group intervention

Eye-movement training (ET) has been proposed as a way to support balance, but its feasibility and long-term effects in children are unclear. We evaluated a 24-week home-based ET program, delivered via the SUKUBARA® video system, in community-dwelling school-aged children, focusing on balance and ocular motor-related visual functions. In this single-arm study, community-dwelling school-aged children performed a daily ET program combining pursuit, saccadic, and Vestibulo-Ocular Reflex x2-based exercises while watching an instructional video at home. Adherence was quantified from automatically recorded video playback time (sessions/week). The primary outcome was the index of postural stability (IPS) of four types. Secondary outcomes were one-leg standing time (OLS; eyes open/closed), grip strength, jump height, and two ocular motor-related functional tests: eye–hand coordination (EHC) and horizontal moving digit identification (HDI). Appropriate statistical analyses were performed, with statistical significance set at p < 0.05. Among the 30 participants, 28 completed the study (mean age 10 ± 1 years; 12 girls [43%]). The total video viewing time over the 24-week period was 9.2 ± 3.6 h (equivalent to 4.6 ± 1.8 sessions/week). Pre-post comparisons revealed significant improvements in EHC (33 ± 5 to 36 ± 5; p < 0.001), HDI (12 ± 3 to 14 ± 4; p = 0.010), OLS with eyes closed (23 [11, 44] to 35 [19, 52]; p = 0.004), and grip strength (16.5 [13.8, 18.1] to 18.0 [14.5, 20.5]; p = 0.002). In contrast, no significant changes were observed in IPS of four types, jump height and OLS with eyes opened. Furthermore, correlation analyses between change scores and training frequency showed a significant positive correlation only with EHC ( r = 0.570, p = 0.003). Our findings suggest that a 24-week home-based eye-movement training program with SUKUBARA® was feasible for school-aged children and has the potential to improve ocular motor-related visual function. However, the effects on balance were limited and require confirmation in controlled trials. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; Registration No. UMIN000055747; date of registration: November 4, 2024; prospectively registered). No medical devices were used in this study.